Everything you need to know about your pelvic floor – before, during and after pregnancy

Posted on April 25th, 2019

Your pelvic floor plays a key role in everything from supporting your baby during pregnancy, to maintaining bladder control and rebuilding a strong core after birth. Here’s what you need to know. Compiled by Tammy Jacks

Your pelvic floor before, during and after pregnancy

When it comes to carrying a baby, giving birth and bouncing back soon after, there’s no doubt your body is nothing short of amazing. And while many organs, muscles and tissues play a part in maintaining a healthy pregnancy, your pelvic floor is, arguably, one of the key areas that needs to be strong before, during and after pregnancy. In fact, the stronger your pelvic floor is before pregnancy, the sooner you’ll bounce back after birth, provided you have a normal, healthy pregnancy and birth, with no complications.

ALSO SEE: What to expect from your post-baby body

Pre- and postnatal exercise specialist, certified nutritionist and mom of two, Giorgina Slotar, offers tips to avoid diastasis recti (the separation of the main abdominal muscles that can contribute to a bulging belly or “pooch” after birth).

What is the pelvic floor?

“Your pelvic floor is an umbrella term that refers to layers of muscle and other tissues that stretch like a hammock from your tailbone to your pubic bone,” explains Giorgina.

What is the role of your pelvic floor before, during and after pregnancy?

Your pelvic floor muscles are important, because they help to support your uterus during pregnancy, as well as your bladder and colon, says Giorgina. They also help these organs function correctly before, during and after pregnancy by stopping the passage of urine or faeces when you need to go to the toilet but can’t find one immediately, for instance. Your pelvic floor muscles also play a key role in sexual function, because the entire area needs to contract and relax in order to enjoy intercourse and have an orgasm… who knew!

Research also shows the pelvic floor works as part of your entire core area to support your back and spine, as well as your breathing patterns and any movement – including lifting groceries and holding your baby.

How does pregnancy affect your pelvic floor?

As your baby grows and your uterus expands, so your bladder and urethra change too. For example, “The angle between the bladder neck and urethra increases, which causes an increased opening of the bladder neck. Hormonal changes during pregnancy also contribute to shifts and changes in the bladder neck, and this, combined with the increased pressure of your growing baby, can affect your pelvic floor,” explains Giorgina.

Therefore, regaining strength in your pelvic floor region is important to help prevent: 

  • Pelvic organ prolapse (when the muscles and tissues supporting your organs such as your uterus and bladder, become weak and loose).
  • Irregular bladder and bowel function (incontinence)
  • Decreased sexual sensation or discomfort during sexual intercourse.
  • “Studies have also concluded that women who have a C-Section can be as likely to have pelvic floor complications as those who have a vaginal delivery,” says Giorigina. “This is due to the pressure that pregnancy and your growing baby place on the pelvic floor,” she adds.

ALSO SEE: Urinary incontinence and pregnancy

Why is a strong pelvic floor important?

“If your pelvic floor is weak before, during or after pregnancy, it’s important to regain the strength in that area before attempting any exercise regime. The pelvic floor and the entire core area acts as an important stabiliser for your body during any movement as it’s connected to many other muscle groups,” explains Giorgina.

What is the link between diastasis recti and the pelvic floor?

Having a strong, deep core is not only beneficial during pregnancy, labour and birth, it has also been found to reduce the incidence of pelvic floor problems and diastasis recti after birth. “While it’s normal for the abdominal muscles to separate during pregnancy, you don’t want them to stay separated for too long after birth,” says Giorgina.

With diastasis recti, the right and left halves of your rectus abdominis muscle spread apart at your body’s midline fascia – known as the linea alba, due to the growing weight of your pregnant belly, explains Giorgina. This gap is roughly 2.7cm or three or more figers wide, and it temporarily weakens your abdominal muscles and can aggravate pelvic instability, which can cause lower back pain and postural problems.

During pregnancy, it’s not a good idea to put excessive downward pressure on your abdominal region, seeing there’s already extra weight pushing on your abdominals. Avoid doing exercises like planks and push-ups, or any exercises that cause abdominal coning, which is when you see a ridge or bulge popping out down the midline of your pregnant belly.

ALSO SEE: Why do I still look pregnant?

“I always advise clients to take it easy after birth and give the body the chance to heal. The gap caused by diastasis recti can take a while to close, but the good news is, it can be fixed with the correct abdominal rehab within the first few months after giving birth.”

If you suspect that you have diastasis recti, it’s important to see an exercise specialist who can advise you on safe exercises to do, post pregnancy, as it is extremely important to be stregthening your deep core in order to mend the gap and avoid traditional exersises that invovle lifting your head up off the floor into a crunch position.

Strengthening your pelvic floor

Giorgina recommends the following key exercises:

Pelvic lifts

These can be done anytime, anywhere during the day – whether you are sitting, standing, lying down or even stuck in traffic, as it merely involves breathing and squeezing.

  • Start by taking a deep breath into your belly, allowing it to expand.
  • As you exhale, draw all the muscles around your pelvic regoin up and in. This movement should feel like you’re squeezing and lifting up into your vagina, much like the feeling of trying to stop passing wind or urine.
  • Perform 8-12 strong lifts, 3 times per day.
  • Hold each lift 6-8 seconds followed immediately by 3-4 fast lifts.
  • Rest for 6 seconds.

Kegels

  • To do a Kegel exercise, simply tighten the muscles you’d use when stopping the flow of urine, hold for a second or two, then release. You can perform this move seated, standing or lying down. When you perform a Kegel, it’s an isolated move and you shouldn’t feel anything else working, such as your abs or glutes.
  • Aim for 3 sets of 10 reps per day.

Pelvic tilts

  • Start by lying flat on an exercise mat, with your knees bent and feet flat on the floor. You will have a little gap between the floor and your lower back.
  • Take a deep breath in and allow your stomach and rib cage to expand. You want to breathe deeply into your belly, allowing it to rise.
  • As you exhale, tilt your pelvis up towards your belly button while simultaneously performing a Kegel and pressing your lower back flat into the floor. You shouldn’t feel all your abdominals working as this is a very specific, isolated movement.
  • Hold this position for 2 seconds before beginning your next breath.
  • Repeat this move to complete 4 – 5 sets of 10 repetitions.

Here’s how to perform a Supine Pelvic Tilt:

 

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Following on from my post on Monday, highlighting the importance of pelvic strength pre, during and post pregnancy, I have had had a few requests to demonstrate how to effectively strengthen your pelvic floor. . The long answer would be that there are many ways to strengthen your pelvic floor and to be honest you can do them throughout your day, whether sitting, standing or lying down … or even going to the bathroom. You should always be mindful of engaging your deep core to encourage correct posture etc. as well as while working out and performing any exercise to encourage correct alignment. . But the short answer would be one of the most commonly performed pelvic floor exercises: THE PELVIC TILT, which I have demonstrated in my video in a supine (lying down) position. . Watch the video carefully, taking into account this detailed step by step instruction: . 1️⃣Start by lying flat on your mat, with your knees bent and feet flat on the floor. You will have a little gap between the floor and your lower back. 2️⃣Take a DEEP breath in and allow your stomach and rib cage to expand. You want to breathe deeply into your BELLY, allowing it to rise. 3️⃣As you exhale, tilt your pelvis up towards your belly button while simultaneously performing a Kegel and pressing your lower back flat into the floor. You should not feel all your abdominals working as this is a very specific, isolated movement of the pelvic floor. Think about gripping a torch light with your belly button- the light would be facing the ceiling in your starting position and as you tilt your pelvis, it would move towards your head. Hold this position for 2 seconds before beginning your next breath. . ??Repeat this movement for at least 10 repetitions and about 4-5 sets. . . . . . #PelvicHealth #PelvicStrength #PostpartumRehab

A post shared by GIORGINA SLOTAR (@giorginaslotar) on

To contact Giorgina, visit www.giorginaslotar.com. 

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About Tammy Jacks

Tammy is a wife, mom and freelance writer with 15 years’ experience in the media industry. She specialises in general lifestyle topics related to health, wellness and parenting. Tammy has a passion for fitness and the great outdoors. If she’s not running around after her daughter, you’ll find her off the beaten track, running, hiking or riding her bike.